SEC Form 4 · accession 0001140361-17-000806

KINGSTONE COMPANIES, INC. · KINS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Jack D Seibald

Director

Period of report

Jan 4, 2017

Accepted (ET)

Jan 5, 2017 · 5:41 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000033992

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F3,F2	Jan 4, 2017	A	2,000	$0.00	A	137,323	D
Common Stock	holding	—	—		—	174,824	I	Retirement Trust
Common Stock^F4	holding	—	—		—	4,600	I	See footnote

Table II — derivative securities

No Table II lines on this filing.

Explanation of responses

F1Received as director fees. Vests to the extent of 667 shares on each of January 4, 2018 and 2019 and 666 shares on January 4, 2020.
F2Includes 3,333 shares received as director fees. Vests to the extent of 1,334 shares on January 4, 2018, 1,333 shares on January 4, 2019 and 666 shares on January 4, 2020.
F3Includes 113,000 shares jointly owned with Mr. Seibald's wife.
F4Shares are owned by a limited partnership. Mr. Seibald may be deemed to have an indirect pecuniary interest in 100 shares owned by the limited partnership based upon his status as a general partner of the limited partnership and may be deemed to have an indirect pecuniary interest in an additional 4,500 shares owned by the limited partnership based upon his wife's status as a limited partner of the limited partnership. The filing of this form shall not be deemed an admission that Mr. Seibald is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any shares owned by the limited partnership.

Remarks

This filing shall not be deemed an admission that the Reporting Person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securities covered by this statement.